Digestive Diseases and Sciences最新文献

{"title":"Prognostic Accuracy of Transient Elastography-Based Predictors in Diabetes and Obesity: A Multicenter International Cohort Study.","authors":"Venkata Sai Jayakrishna Jasty, Esteban Urias, Kai Le Ashley Tiong, Majd Bassam Aboona, Michael Song, Claire Faulkner, Pooja Devan, Jean Ee Neo, Karn Wijarnpreecha, Yu Jun Wong, Vincent Lingzhi Chen","doi":"10.1007/s10620-024-08635-y","DOIUrl":"10.1007/s10620-024-08635-y","url":null,"abstract":"<p><strong>Background/aims: </strong>Liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE) is recommended for risk stratification of patients with nonalcoholic fatty liver disease (NAFLD). More recently, AGILE3 + and AGILE4 have combined LSM with clinical parameters to identify patients with advanced fibrosis and cirrhosis, respectively. However, there are limited data on prognostic performance of these scores in key at-risk subgroups such as those with diabetes and obesity compared to LSM alone.</p><p><strong>Methods: </strong>This is a retrospective cohort study including 1903 adult patients with NAFLD from tertiary care centers in the United States and Singapore undergoing VCTE between 2015 and 2022. Primary predictors were FAST, LSM, AGILE3 + , and AGILE4 scores and the primary outcome was liver-related events (LRE). Patients were further stratified by diabetes and obesity status. Prognostic performance was measured using the time-dependent area under the receiver operating characteristic curve (tAUC) at 5 years.</p><p><strong>Results: </strong>In total, 25 LRE occurred and the overall incidence rate of LRE was 4.4 per 1000 person-years. tAUC for predicting LRE in the overall group was significantly higher with AGILE3 + (0.94 [95% CI: 0.90-0.98]) and AGILE4 (0.94 [95% CI: 0.90-0.98]) compared to LSM (0.87 [95% CI: 0.80-0.94]) (p = 0.001 and 0.009, respectively) and FAST (0.73 [95% CI: 0.59-0.86]) (p < 0.001 for both). Similarly, tAUC was significantly higher in those with T2D for AGILE3 + compared to LSM (0.92 vs 0.86, respectively) (p = 0.015) and FAST (0.92 vs 0.73, respectively) (p = 0.008). Among people with obesity, tAUC was significantly higher for AGILE3 + compared to LSM (0.95 vs 0.89, respectively) (p = 0.005) and FAST (0.95 vs 0.76, respectively) (p = 0.0035). Though AGILE4 had a higher tAUC in these subgroups compared to LSM, it did not reach statistical significance.</p><p><strong>Conclusion: </strong>AGILE3 + significantly outperforms LSM and FAST for predicting LRE in patients with NAFLD including in those with diabetes or obesity.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4240-4249"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of a Low-FODMAP Diet in Combination with a Gluten-Free Diet for Adult Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.","authors":"Jing Zhang, Ping Yu, Yang Xu, Xiao Yun Lu, Yan Xu, Jun Hang, Yu Zhang","doi":"10.1007/s10620-024-08671-8","DOIUrl":"10.1007/s10620-024-08671-8","url":null,"abstract":"<p><strong>Background: </strong>Common gastrointestinal disease irritable bowel syndrome (IBS) is marked by symptoms like changed bowel habits, bloating, and stomach ache. A low-FODMAP combined gluten-free diet (LF-GFD) has been suggested as a possible therapy for IBS symptoms management.</p><p><strong>Objective: </strong>This study sought to investigate whether a LF-GFD would help patients with IBS.</p><p><strong>Methods: </strong>Strict inclusion and exclusion criteria from internet databases helped to identify clinical studies evaluating the intervention of LF-GFD in the treatment of IBS patients. Using measurements including the visual analog scale (VAS) for bloating and pain, the IBS symptom severity scale (IBS-SSS), and IBS quality of life (IBS-QoL), the main results evaluated were the efficacy of LF-GFD in reducing IBS symptoms. Furthermore assessed were the psychological impacts of LF-GFD utilizing the self- rating depression scale (SDS) and self- rating anxiety scale (SAS).</p><p><strong>Results: </strong>A total of 437 patients (221 on LF-GFD diet and 216 on GFD) were involved in 4 randomized controlled trials and 4 cohort studies. The combined results indicated that LF-GFD reduced the VAS bloating ratings (RR = - 0.58, 95%CI - 0.92-0.23, P = 0.0010, I2 = 83%) and the VAS pain scores (RR = - 0.42, 95%CI - 0.66-0.19, P = 0.005, I2 = 58%). In addition, LF-GFD indicated a substantial enhancement in IBS-SSS scores (MD = - 1.42, 95%CI - 2.74-0.10, P = 0.03, I2 = 24%) and IBS-QoL ratings (MD = 3.75, 95%CI 0.98-6.53, P = 0.008, I2 = 33%). Moreover, the LF-GFD group showed a substantial drop in SDS (MD = - 2.56, 95%CI - 3.38-1.74, P < 0.00001, I2 = 65%) and SAS (MD = - 4.30, 95%CI - 6.53-2.24, P < 0.0001, I2 = 0%) scores compared to the GFD group.</p><p><strong>Conclusion: </strong>LF-GFD therapy significantly enhances clinical symptoms and reduces anxiety and depression in individuals diagnosed with irritable bowel syndrome.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4124-4132"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EoE Recurrence on PPI Maintenance Therapy: You Do Not Know if You Do Not Look!","authors":"Ryan Alexander, Blake Kassmeyer, Ryan Lennon, Jeffrey Alexander, Diana Snyder, Karthik Ravi","doi":"10.1007/s10620-024-08676-3","DOIUrl":"10.1007/s10620-024-08676-3","url":null,"abstract":"<p><strong>Background and aims: </strong>Data regarding histologic recurrence of EoE on PPI maintenance therapy are lacking.</p><p><strong>Methods: </strong>Retrospective review of 101 patients with histologic PPI-responsive EoE.</p><p><strong>Results: </strong>52/101 (51%) patients underwent follow-up EGD with biopsies. Of the 52 patients, 29 (56%) maintained histologic remission and 23 (44%) had histologic recurrence. 21 (40%) patients maintained BID PPI, 20 (39%) tapered to QD, and 11 (21%) had discontinued PPI. Of the 21 patients on BID PPI, 7 (33%) had histologic recurrence, of which 6 (86%) were asymptomatic.</p><p><strong>Conclusions: </strong>Patients on PPI therapy for EoE benefit from serial clinical, endoscopic, and histologic surveillance.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4048-4052"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Bile Duct Dysplasia at the Duodenal Anastomosis Site.","authors":"Lijian Wang, Zhenguo Qiao, Xiaolu Yu, Qiufen Yang","doi":"10.1007/s10620-024-08688-z","DOIUrl":"10.1007/s10620-024-08688-z","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"3996-3997"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colonic Perforation Caused by a Monopterus albus.","authors":"Yi Chen, Jun Wang, Shanshan Lin, Hong Lin, Jiamin Xu, Jinshun Zhang","doi":"10.1007/s10620-024-08685-2","DOIUrl":"10.1007/s10620-024-08685-2","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4001-4002"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concise Commentary: Twelve Steps on the Path to Improving Training Programs-Recruiting GI Fellows in 2024 and Beyond.","authors":"Deborah D Proctor","doi":"10.1007/s10620-024-08637-w","DOIUrl":"10.1007/s10620-024-08637-w","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4025-4026"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proinflammatory Diet Increases the Risk of Irritable Bowel Syndrome: A Prospective Study of 129,408 UK Biobank Participants and Mendelian Randomization Analysis.","authors":"Laifu Li, Yan Ran, Yan Zhuang, Ying Xu, Lianli Wang, Lele Chen, Yating Sun, Fangchen Ye, Lin Mei, Fei Dai","doi":"10.1007/s10620-024-08638-9","DOIUrl":"10.1007/s10620-024-08638-9","url":null,"abstract":"<p><strong>Background: </strong>Patients with irritable bowel syndrome (IBS) often have chronic low-grade inflammation in the intestinal mucosa. Some dietary components are known to be associated with inflammation. However, there is currently limited research on the relationship between dietary inflammatory potential and the risk of IBS.</p><p><strong>Methods: </strong>A total of 129,408 participants in the UK Biobank were included in this study. Energy-Adjusted Dietary Inflammatory Index (E-DII) based on 26 nutrients and the Empirical Dietary Inflammatory Pattern (EDIP) based on 17 food groups were constructed, and on the basis of the tertiles, the continuous score was categorized into proinflammatory, neutral, and antiinflammatory categories. Associations between IBS and E-DII and EDIP were investigated by multivariable Cox proportional hazard models. Potential confounders including sociodemographic, lifestyle, body mass index (BMI), psychological state, type 2 diabetes, and thyroiditis were adjusted. In addition, subgroup analysis and sensitivity analysis were also performed. Finally, a two-sample Mendelian randomization (MR) analysis was employed to explore the independent causality of nutrients and dietary-derived serum antioxidants with IBS.</p><p><strong>Results: </strong>In the cohort study, over a median follow-up period of 13.26 years, 2421(1.87%) participants developed IBS. In the E-DII categories, after adjusting for the confounders, individuals in the proinflammatory diet category had a higher risk of IBS compared with the antiinflammatory category (HR 1.15, 95% CI 1.03-1.28, p = 0.015, p trend = 0.017) and neutral category (HR 1.13, 95% CI 1.01-1.26, p = 0.030, p trend = 0.017). In the EDIP categories, after adjusting for the confounders, individuals in the proinflammatory diet category had a higher risk of IBS compared with antiinflammatory category (HR 1.19, 95% CI 1.06-1.33, p = 0.002, p trend = 0.002) but no significant association compared with neutral category (HR 1.10, 95% CI 0.99-1.23, p = 0.067, p trend = 0.002). In the MR analysis, genetically determined intake levels of 16 nutrients and 6 dietary sources of circulating antioxidants did not have a causal effect on IBS.</p><p><strong>Conclusions: </strong>Our findings indicate that proinflammatory dietary components are independent risk factors for IBS. However, there is no causal relationship between individual nutrient intake or serum antioxidants from dietary sources and IBS.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4140-4151"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Criterion Validity of Screening Tools and Field-Based Tests for Health-Related Physical Fitness in Inflammatory Bowel Disease.","authors":"Karlijn Demers, Bart C Bongers, Sander M J van Kuijk, Guy Plasqui, Daisy M A E Jonkers, Marieke J Pierik, Laurents P S Stassen","doi":"10.1007/s10620-024-08682-5","DOIUrl":"10.1007/s10620-024-08682-5","url":null,"abstract":"<p><strong>Background: </strong>Monitoring health-related physical fitness (HRPF) may benefit proactive Inflammatory Bowel Disease (IBD) management. However, knowledge regarding HRPF in patients with IBD is limited and gold standard tests are impractical for widespread use, necessitating simpler methods.</p><p><strong>Aim: </strong>This study evaluated the criterion validity of screening tools and field-based tests compared to gold standard tests for HRPF in patients with IBD.</p><p><strong>Methods: </strong>Adult patients with IBD completed screening tools, field-based tests, and gold standard tests for HRPF. Criterion validity was examined through (intraclass) correlation coefficients and Bland-Altman plots. Predictive capacity of the screening tools was examined with receiver operating curve analysis.</p><p><strong>Results: </strong>Among 53 included patients, screening tools demonstrated poor-to-moderate validity compared to the cardiopulmonary exercise test (CPET) for cardiorespiratory fitness. Very strong correlations were found for four-site skinfold thickness and multi-frequency bioimpedance analysis (BIA) with deuterium oxide dilution for body fat percentage (ICC = 0.90, ICC = 0.93), and between the steep ramp test and CPET (r = 0.95) for cardiorespiratory fitness. The steep ramp test also correlated strongly with isokinetic quadriceps (r > 0.75) and hamstring (r > 0.74) strength. Hand-held dynamometry and the sit-to-stand test showed strong correlations with hamstring strength (r > 0.80, r > 0.76). Negligible correlations were found for field-based tests compared to isokinetic quadriceps and hamstring endurance.</p><p><strong>Conclusions: </strong>Four-site skinfold thickness and BIA showed good agreement with the gold standard for body fat measurement. The steep ramp test demonstrated strong correlations with the gold standard tests for cardiorespiratory fitness and quadriceps and hamstring strength, while hand-held dynamometry and the sit-to-stand test showed strong correlations with hamstring strength.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4072-4088"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychopathology and the Validity of Gastrointestinal Symptom Reporting as Revealed Through Cluster Analyses of MMPI-2-RF Results.","authors":"Paris A Lang, Linda Thomas, Brett A Lidbury","doi":"10.1007/s10620-024-08629-w","DOIUrl":"10.1007/s10620-024-08629-w","url":null,"abstract":"<p><strong>Background: </strong>Psychological state, self-reported gut symptoms, and somatic complaints are recognized relationships that can impact health assessment and subsequent treatment.</p><p><strong>Aim: </strong>To investigate the impact of psychological state and personality on symptom self-reporting and somatization.</p><p><strong>Methods: </strong>Sixty-two (62) participants from the Hunter region of NSW (Australia) undertook a survey of health and lifestyle along with an MMPI-2-RF assessment of personality, psychopathology, and test-taking attitude. Participants also completed the Rome Criteria to assess functional gastrointestinal disorders (FGIDs). To assist the interpretation of MMPI-2-RF results, clustering was applied to identify similar responses and sub-cohort profiles of reporting.</p><p><strong>Results: </strong>Cluster analysis revealed four sub-cohorts, stratified by psychopathology, gut-related symptoms, and the validity of self-reported somatic complaints. Sample clustering identified one sub-cohort defined by high rates of negative affectivity and suicidal ideation. Apart from these differences, clusters were uniform for age, sex, smoking, mental health diagnoses, as well as for gut-related conditions.</p><p><strong>Conclusion: </strong>Results provide further evidence of the interaction of the gut-brain axis and its relationship to serious mental health conditions. It also points to the need to assess the veracity of self-reported symptomatology that may be both pathognomonic for psychopathology but might also be a consequence of gut dysbiosis. Clustering assisted these investigations by defining distinct sub-cohorts based on participant MMPI-2-RF responses.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4063-4071"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AFP-DIAM Score to Predict Survival in Patients with Hepatocellular Carcinoma Before TACE: A French Multicenter Study.","authors":"Estelle Rebillard, Nicolas De Abreu, Benjamin Buchard, Léon Muti, Mathieu Boulin, Bruno Pereira, Benoit Magnin, Armand Abergel","doi":"10.1007/s10620-024-08639-8","DOIUrl":"10.1007/s10620-024-08639-8","url":null,"abstract":"<p><strong>Background: </strong>Transarterial chemoembolization (TACE) is recommended as a palliative treatment for patients of the B stage of the Barcelona Clinic Liver Cancer (BCLC) classification.</p><p><strong>Aims: </strong>To identify clinical, biological, and radiological predictors of survival in patients undergoing TACE and develop a pre-therapeutic prognostic score.</p><p><strong>Methods: </strong>191 adult cirrhotic patients treated for HCC with TACE at the University Hospital (UH) of Clermont-Ferrand (France) from 2007-2017 were retrospectively included. We investigated the impact of baseline liver function, patient characteristics, and tumor burden on overall survival and developed a prognostic score.</p><p><strong>Results: </strong>Patients had a median age of 66 years and 126 patients were Child A. The AFP-DIAM score distinguishes two groups with a significant difference in survival time (median OS 28.3 months in patients with a score = 0 versus 17.7 months in patients with a score > 0). AFP-DIAM was validated on an external cohort, is well calibrated, and has the best discrimination capacity (C-index) as compared to NIACE, HAP, STATE, and SIX TO TWELVE. AFP-DIAM and SIX TO TWELVE are the more easy-to-use scores. When AFP-DIAM and the SIX TO TWELVE scores were tested in the same statistical model, results confirmed a better AFP-DIAM performance.</p><p><strong>Conclusions: </strong>The AFP-DIAM is an easy-to-use score which allows to distinguish two groups with different prognosis before the first TACE session. Its use could provide further support to BCLC system to guide the therapeutic strategy of patients with HCC.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4259-4267"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}